A Fascia

a fascia is a sheath, a sheet, or any other dissectible aggregations of connective tissue that forms beneath the skin to attach, enclose, and separate muscles and other internal organs


Acupuncture interventions are defined in accordance with the World Health Organization as body needling (traditional, medical, modern, dryneedling, trigger point needling, etc.), moxibustion (burning of herbs), electroacupuncture, laser acupuncture, microsystem acupuncture (such as ear acupuncture), and acupressure (application of pressure at acupuncture points).


a fibrous band of connective tissue that develops in response to inflammation, trauma, or surgery, resulting in the union of two adjacent structures.


pain due to a stimulus that would not normally cause pain, such as light touch or mild changes in temperature.

Biopsyochosocial Approach

The biopsychosocial approach systematically considers biological, psychological, and social factors and their complex interactions in understanding health, illness, and health care delivery.

Clinical massage

Soft tissue therapies intended to target muscles with specific goals such as relieving pain, releasing muscle spasms or improving restricted motion, performed by a practitioner.

Clinical practice guideline

A systematically developed statement that aims to assist clinicians in providing quality care to patients.

Cognitive behavioural therapy

A therapy that is used to help people think in a healthy way with a focus on thought (cognitive) and action (behavioral).


The local use of low temperatures (e.g., ice).

Cupping massage

A form of massage which utilizes cupping glasses being moved over the skin once suction (negative pressure) is created. The aim is to increase local blood circulation and relieve muscle tension.

Descending modulation

The process by which pathways that descend from the brain to the spinal cord modify incoming somatosensory information so that the perception of and reactions to somatosensory stimuli are altered, resulting in increased or decreased pain.

Ectopic discharge

Trains of ongoing electrical nerve impulses that occur spontaneously without stimulation or originate at sites other than normal location (or both). This phenomenon typically occurs after nerve injury.

Electric Muscle Stimulation (EMS)

A passive physical modality that stimulates muscle contraction by electrical impulses.


The stimulation of inserted acupuncture needles with an electrical current. The frequency and intensity of the electrical stimulation may vary.


the site of insertion of tendons or ligaments into bones.

Evidence based medicine

Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research.


Any series of movements with the aim of training or developing the body by routine practice or as physical training to promote good physical health.


thickening and scarring of connective tissue, most often a consequence of inflammation or injury.

General exercise program

An exercise program incorporating aerobic exercises, stretching, strengthening, endurance, co-ordination and functional activities for the whole body.

Guided imagery

A technique used to induce relaxation. Recordings are designed to help individuals visualize themselves relaxing or engaging in positive changes or actions. State of awareness is similar to that of a meditative status.

High-value care

An intervention in which evidence suggests it confers benefit on patients, or probability of benefit exceeds probable harm, or, more broadly, the added costs of the intervention provide proportional added benefits relative to alternatives.

Informed Consent

This term describes an approach to care that ensures clients understand a therapeutic approach fully before giving consent to begin. When therapists establish informed consent, they fully disclose the purpose and benefits of a treatment approach to their client. They discuss any potential problems that might arise, what parts of the body will be massaged, how the client will be draped. Therapists empower clients to state any concerns or ask questions that they may have. Before proceeding, the therapist explicitly asks for permission to begin.


Interoception refers to the representation of the internal world, and includes the processes by which an organism senses, interprets, integrates, and regulates signals from within itself.

Ischemic compression

A soft tissue therapy that involves sustained pressure to a muscle that is applied with the hand or a device, performed by a health care professional.

Kinesio tape

A thin, pliable adhesive tape applied to the skin.

Low-value care

An intervention in which evidence suggests it confers no or very little benefit for patients, or risk of harm exceeds probable benefit, or, more broadly, the added costs of the intervention do not provide proportional added benefits.


Manual treatment applied to the spine or joints of the upper or lower extremity that incorporates a high velocity, low amplitude impulse or thrust applied at or near the end of a joint’s passive range of motion.

Manual therapy

Techniques that involve the application of hands-on and/or mechanically assisted treatments, including manipulation, mobilization, and traction.


Massage is a patterned and purposeful soft-tissue manipulation accomplished by use of digits, hands, forearms, elbows, knees and/or feet, with or without the use of emollients, liniments, heat and cold, hand-held tools or other external apparatus, for the intent of therapeutic change.

Massage Therapy

Massage therapy consists of the application of massage and non-hands-on components, including health promotion and education messages, for self-care and health maintenance; therapy, as well as outcomes, can be influenced by: therapeutic relationships and communication; the therapist’s education, skill level, and experience; and the therapeutic setting.


specialized sensory neurons that normally detect mechanical stimuli. In the peripheral nervous system (PNS), different subtypes of mechanoreceptors are present that are specialized for the detection of different mechanical stimuli (e.g., vibration, light touch, firm touch).


Mechanotherapy refers to any intervention that introduces mechanical forces with the goal of altering molecular pathways and inducing a cellular response that enhances tissue growth, modeling, remodeling, or repair.


Mechanotransduction refers to the conversion of a biophysical force into a cellular and molecular response.


Manual treatment applied to the spine or joints of the upper or lower extremity that incorporates a low velocity and small or large amplitude oscillatory movement, within a joint’s passive range of motion.

Multimodal care

Treatment involving at least two distinct therapeutic modalities, provided by one or more health care disciplines. The following were considered distinct therapeutic modalities: passive physical modalities; exercise; manual therapy which includes mobilization, manipulation or traction; acupuncture; education; psychological interventions; and soft tissue therapies.

Muscle energy technique

A soft tissue therapy performed by a health care professional that involves a stretch to the muscle after the muscle was contracted against resistance.

Myofascial Release Therapy

A soft-tissue therapy aimed at relaxing contracted muscles and improving blood and lymph circulation in associated tissues. It uses slow and sometimes deep pressure applied directly to tissues.

Neurogenic inflammation

inflammation evoked by the release of neuropeptides and inflammatory mediators that are produced directly by peripheral nociceptor afferents.

Neuropathic pain

Pain caused by a lesion or disease of the somatosensory nervous system


The brain's ability to reorganize itself by forming new neural connections throughout life.

Nociceptive pain

Pain that arises from actual or threatened damage to non-neural tissue and is due to the activation of nociceptors.

Nociplastic pain

Pain that arises from altered nociception despite no clear evidence of actual or threatened tissue damage causing the activation of peripheral nociceptors or evidence of disease or lesion of the somatosensory system causing the pain.


Provision of a service that is unlikely to increase the quality or quantity of life, that poses more harm than benefit, or that patients who were fully informed of its potential benefits and harms would not have wanted.


An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.

Patient education

A process to enable individuals to make informed decisions about their personal health-related behaviour.

Relaxation massage

A group of soft tissue therapies intended to relax muscles, performed by a practitioner.

Relaxation training

Used to guide individuals to relax muscles not needed for various daily Activities. This may include progressive relaxation training (different muscle groups are systematically tensed and relaxed) or autogenic relaxation training (self-control of the body’s physiological reactions).

Right care

Care that is tailored for optimising health and wellbeing by delivering what is needed, wanted, clinically effective, affordable, equitable, and responsible in its use of resources.

Shared decision-making

Shared decision making is a consultation process where a clinician and patient jointly participate in making a health decision, having discussed the options and their benefits and harms, and having considered the patient's values, preferences and circumstances.

Shock-wave therapy

A passive physical modality that is placed onto the skin; it involves acoustic waves associated with a sudden rise in pressure and are generated by electrohydraulic, piezoelectric and electromagnetic devices to send sound waves into areas of soft tissue.

Short term

Less than three months.

Soft tissue therapy

A mechanical therapy in which muscles, tendons, and ligaments are passively pressed and kneaded by hand or with mechanical devices.

Spinal manipulation

Manual therapy applied to the spine that involves a high velocity, low amplitude impulse or thrust applied at or near the end of a joint’s passive range of motion.


A soft tissue therapy that involves applied pressure to a muscle with positioning of the neck to provide a small stretch a muscle, performed by a practitioner.


An architectural system where the structures stabilize themselves by balancing countering forces of tension and compression.

The Fascial System

The fascial system consists of the three-dimensional continuum of soft, collagen-containing, loose and dense fibrous connective tissues that permeate the body. It incorporates elements such as adipose tissue, adventitiae and neurovascular sheaths, aponeuroses, deep and superficial fasciae, epineurium, joint capsules, ligaments, membranes, meninges, myofascial expansions, periostea, retinacula, septa, tendons, visceral fasciae, and all the intramuscular and intermuscular connective tissues including endo-/peri-/epimysium.


Manual or mechanically assisted application of an intermittent or continuous distractive force.

Transcutaneous Electrical Nerve Stimulation (TENS)

A passive physical modality connected to the skin, using two or more electrodes to apply low level electrical current. Typically used with the intent to help pain management.

Triggerpoint Therapy

A form of clinical massage where pressure and/or longitudinal stroking is applied over a trigger point in a muscle.


Failure to deliver a service that is highly likely to improve the quality or quantity of life, that represents good value for money, and that patients who were fully informed of its potential benefits and harms would have wanted.


An ancient Indian practice involving postural exercises, breathing control, and meditation.


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Evidence-Based Massage Therapy by Richard Lebert is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.

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